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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Risk factors were studied in 96 children with congenital hydrocephalus (CH) coming from 118,265 consecutive births of known outcome. Hydrocephalus with neural tube defects, intracranial tumors or secondary to brain atrophy were excluded. The prevalence of CH was 0.81 per thousand. Diagnosis was performed prenatally in 41 cases. Forty-three (44.8%) of the cases had hydrocephalus without other malformations (isolated hydrocephalus), 18 (18.7%) infants had recognized chromosomal or non-chromosomal syndromes and 35 children (36.4%) had multiple malformations. Each case was matched to a control. Weight and length at birth of children with hydrocephalus were less than in the controls (p < 0.001). The weight of the placenta was lower than in the controls (p < 0.05). The pregnancy with a hydrocephalic child was more often complicated by threatened abortion, polyhydramnios and oligohydramnios. The mothers of children with hydrocephalus and multiple malformations had used oral contraceptives during the first trimester of pregnancy more often than the mothers of the controls. No differences appeared between the mothers of children with CH and the controls for the other risk factors studied: parental age, parity, previous pregnancies, previous stillbirths, smoking, diabetes, epilepsy, X-rays, hypertension, fever "flu", medication and occupational exposure. There was an increase of parental consanguinity in the parents of our patients (6.2% v. 1.1%, p < 0.001) and first degree relatives had more non-cerebral malformations than the controls (7.3% v. 3.2%, p < 0.05).
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PMID:An epidemiologic study of environmental and genetic factors in congenital hydrocephalus. 129 84

A rare case of trochlear nerve neurinoma is described. Including this case, the number of reported intracranial tumors arising from the sheaths of the third, fourth, and sixth cranial nerves is 38. By site and relationship to the nerve segment, they fall into three groups: cisternal, cisternocavernous, and cavernous. In cisternal tumors of the third and sixth nerves, paresis of the nerve hosting the tumor is the unique nerve deficit; by contrast, in those of the fourth nerve, paresis of the trochlear nerve can be absent and that of the third nerve present. In the latter tumors, a peculiar ataxic hemiparesis syndrome is produced by midbrain compression. Cisternocavernous neurinomas often cause symptoms of intracranial hypertension, while cavernous neurinomas bring about two clinical features: paresis of one or more nerves of the cavernous sinus and a clinicoradiological orbital apex syndrome. At surgery, generally cisternal neurinomas are totally removed and the nerve source of the tumor identified; in cisternocavernous and cavernous neurinomas, total removal of tumor and identification of the parent nerve have been reported in only half of the cases. In the majority of parasellar neurinomas, clinical differences can be found between those arising from the nerves governing eye movement and those arising from the gasserian ganglion.
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PMID:Neurinoma of the third, fourth, and sixth cranial nerves: a survey and report of a new fourth nerve case. 144 Feb 7

The term "papilledema" describes optic disc swelling resulting from increased intracranial pressure. A complete history and direct funduscopic examination of the optic nerve head and adjacent vessels are necessary to differentiate papilledema from optic disc swelling due to other conditions. Signs of optic disc swelling include elevation and blurring of the disc and its margins, venous congestion, and retinal hard exudates, splinter hemorrhages and infarcts. Patients with papilledema usually present with signs or symptoms of elevated intracranial pressure, such as headache, nausea, vomiting, diplopia, ataxia or altered consciousness. Causes of papilledema include intracranial tumors, idiopathic intracranial hypertension (pseudotumor cerebri), subarachnoid hemorrhage, subdural hematoma and intracranial inflammation. Optic disc edema may also occur from many conditions other than papilledema, including central retinal artery or vein occlusion, congenital structural anomalies and optic neuritis.
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PMID:Papilledema: clinical clues and differential diagnosis. 154 98

Three cases of subdural hematoma caused by intracranial tumors are presented. In one case sudden worsening of patient's condition was due to intracerebral and subdural hemorrhage. In the other one tumor manifested by intracranial hemorrhage and the patient was initially diagnosed as SAH. In this case only the capsule of hematoma was found during operation; spontaneous resolution of hematoma took place. In the third case tumor and hematoma were localized in posterior fossa. Two weeks before admission to the hospital the patient develops symptoms of mild intracranial hypertension, probably due to the growth in space occupying lesion volume, which was caused by the origin of hematoma. In all cases tumors were highly vascularized and showed tendency to bleeding. There was no history of trauma in any case.
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PMID:Subdural hematoma caused by cerebral tumors. 302 11

A series of 4992 intracranial procedures performed over an 11-year period was evaluated for the occurrence of postoperative hemorrhage. Forty patients (0.8%) experienced postoperative hemorrhage. Twenty-four hemorrhages were intracerebral (60%), 11 were epidural (28%), 3 were subdural (7.5%), and 2 were intrasellar (5.0%). Hematomas in 33 patients occurred at the operative site, and 7 occurred remote from the operative site. Intracranial tumor was the reason for operation in 56% of the patients developing a clot, and meningioma was the most common tumor associated with this complication. The use of the sitting position was not associated with an increased incidence of postoperative hemorrhage. Disturbances of coagulation and hypertension seemed to be potential precipitating factors. Postoperative hemorrhage was recognized within 12 hours of operation in 35% of the patients. An altered level of consciousness was the most frequent clinical finding, present in all patients. There was no clear relationship between the time of recognition and the final clinical outcome. Parenchymal clots carried the worst prognosis, accounting for 8 of the 11 deaths and all 7 patients with poor neurological outcome.
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PMID:Postoperative hemorrhage: a survey of 4992 intracranial procedures. 322 12

An exceptional case of a large intracranial extradural lymphoma arising from the skull and causing intracranial hypertension syndrome, in the absence of other localizations elsewhere in the body is described. Only another similar observation was reported in the literature. The diagnosis of this exceptional localization of lymphomas, which can mimic other intracranial tumors, is discussed on the basis of the computer-tomography findings and the usefulness of the radiotherapy is pointed out.
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PMID:Primary lymphoma of the cranial vault. 345 61

This review deals with steroid hormones and receptors in relation to the physiology and the pathology of the central nervous system (CNS) and meninges. In recent years experiments performed in animals showed that: 1) endogenous steroid hormones cross the blood brain barrier: 2) radiolabelled steroid hormones bind in specific areas of the CNS; 3) all five classes of steroid receptors, i.e. oestrogen, progesterone, androgen, glucocorticoid and mineralocorticoid receptors (OR, PR, AR, GR, MR), are present in brain tissues, especially in the hypothalamus and the limbic system; 4) the interaction of steroid hormones and specific receptors induces the synthesis of proteins in the CNS; 5) finally, in situ metabolism of steroid hormones has been evidenced by the presence of specific enzymes. A few studies in human brain tissues have shown the presence of GR and OR as well as enzymes involved in the metabolism of sex steroid hormones. In neurology, some epidemiological and clinical data suggest the implication of steroid hormones and receptors in human CNS: 1) the influence of oestrogens in tardive dyskinesia; 2) the relevance of hormonal changes in benign intracranial hypertension; 3) the usefulness of glucocorticoid therapy in many patients with intracranial tumors and/or edema. Due to feasibility, most researches have concerned tumors: meningioma, neurinoma and glioma. Firstly, a reappraisal of biochemical and histochemical technics used to detect and characterize the receptors in tumors is presented. Then results from the recent literature are reviewed. In meningioma, PR was found in 89 p. 100 (152/177) of the cases, usually at moderate to high levels (up to 33 000 fmol/gT). In addition, PR has been fully characterized from a biochemical point of view. Furthermore, it has been hypothesized that PR may be a marker of leptomeningeal cells since it was detected at high levels in well differentiated tumors provided they had no or few psammoma. This was further supported by the discovery of PR in normal leptomeninges in human adults. OR was detected in 48 p. 100 (87/177) of the meningioma, at low levels. This is in contrast with PR but the percentage of cases with OR raises to 70 p. 100 (42/60) if one considers only tumors assayed for both cytosolic and nuclear receptors. Therefore it has been suggested that OR had translocated into the nucleus, at least in some cases, and subsequently the hypothesis of functional OR in meningioma was raised. AR was also detected in meningioma. Furthermore AR levels were found to correlate well with PR levels.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Steroid receptors in the central nervous system. Implications in neurology]. 637 95

The choroid plexus papillomas are rare neoplasms. They constitute about 0.5 per 100 of all intracranial tumors. From a histological point of view they are generally benign tumors. However they give a high mortality rate due to their location near vital structures, the rapid production of intracranial hypertension, and the rich vascularity making risky the surgical treatment.
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PMID:[Ultrastructural study of papillomas of the choroid plexus]. 657 73

Pheochromocytoma accounts for about 0.1 per cent of patients with diastolic hyperstension. It mimics many diseases varying from anxiety psychoneurosis to intracranial tumors. Cardinal symptoms include sevre headache (72 to 92 per cent), sweating (60 tp 70 per cent), palpitations (51 to 73 per cent), and hypertension (> 90 per cent) of which 50 per cent is sustained, 50 per cent paroxysmal. Many drugs (phenothiazines, Saralasin, antiemetics, steroids, etc.) have been reported as precipitating factors. Patients who should be screened for pheochromocytoma include: (1) all symptomatic patients with sustained or paroxysmal hyperstension; (2) asymptomatic hypertension; (3) all patients with MEA 2a,b (hyperparathyroidism, medullary carcinoma of the thyroid, neurocutaneous lesions) and their first degree relatives, even if the latter are asymptomatic and normotensive; (4) hypertension plus diabetes mellitis or hypermetabolism; (5) hypertensive episode during induction of anesthesia or radiologic procedure; and (6) hypertensive response during histamine administration, i.e., gastric analysis. Urinary metanephrine is the single best screening test. Plasma catecholamine determination is particularly helpful when collected before and immediately after an attack. Provacative agents (histamine, glucagon, tyramine) are needed rarely. Preoperative localization of the tumor can be done with nephrotomography IVP, computerized axial tomography, ultrasound, 131-I-19-iodocholesterol scan, arteriography, venography.
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PMID:Pheochromocytoma: clinical manifestations and diagnostic tests. 745 90

We report a case of dermoid cyst arising in the cavernous sinus and parapharyngium areas through the foramen lacerum. A 12-year-old girl was hospitalized in October 1966 for progressive intracranial hypertension. CT before a prior surgical intervention in 1994 showed an intracranial process suggesting a dermoid cyst. CT performed in October 1996 showed a temporal process at the left side measuring 8 cm x 5 cm and well circumscribed with a thin wall. This process extended towards the parapharyngium area through the foramen lacerum. The exocranial part measured 4 cm in diameter. The density of the process strongly suggested a mature dermoid cyst with fatty and calcium components. The histology study confirmed the diagnosis of dermoid cyst. The frequency of intracranial dermoid cysts is 2 to 3 times less than that of epidermoid cysts. This is an uncommon process accounting for 1% of intracranial tumors occurring in children. In the sustentorial spaces, the process occurs more frequently in the parasellar area. To our knowledge, exocranial extension has not been reported to date.
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PMID:[Cavernous sinus dermoid cyst with unusual parapharyngeal development]. 1097 Sep 66


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